Supportive Care in Cancer

, Volume 27, Issue 2, pp 573–581 | Cite as

Radiotherapy for cutaneous head and neck cancer and parotid tumours: a prospective investigation of treatment-related acute swallowing and toxicity patterns

  • Laura B. MoroneyEmail author
  • Jennifer Helios
  • Elizabeth C. Ward
  • Jane Crombie
  • Clare L. Burns
  • Shu Qi Yeo
  • Anita Pelecanos
  • Ann-Louise Spurgin
  • Claire Blake
  • Lizbeth Kenny
  • Benjamin Chua
  • Brett G. M. Hughes
Original Article



Reports of acute treatment-related dysphagia and toxicities for patients with parotid tumours or cutaneous head and neck cancer (HNC) are limited. This study aimed to describe the severity and timing of dysphagia and related toxicities experienced during radiotherapy for cutaneous HNC and parotid tumours, to inform the nature of future speech pathology (SP) service models required during treatment.


Prospective study of 32 patients with parotid tumours and 36 with cutaneous HNC undergoing curative non-surgical management. Dysphagia and acute toxicity data was collected weekly during treatment and at 2, 4 and 12 weeks post-treatment using the Functional Oral Intake Scale, diet descriptors and CTCAE v4.0.


In both groups, minimal treatment toxicities (grades 0–1) were observed. Xerostomia and dysgeusia were the most frequently reported grade 2 toxicities. Only 3% of parotid patients and 6% with cutaneous HNC experienced grade 3 dysphagia. Full or soft texture diets were maintained by > 70% of patients in both groups. Symptoms peaked in the final week of treatment and rapidly improved thereafter. Apart from xerostomia < 10% of patients had any grade 2 toxicity at 12 weeks post-treatment.


Patients in these subgroups of HNC experienced minimal treatment-related toxicity during radiotherapy. As such, the need for supportive symptom management by SP is low. Models that involve interdisciplinary surveillance of symptoms with referral to SP only when required may be best suited for these individuals to ensure issues are identified whilst minimising patient burden created by unnecessary routine SP appointments.


Dysphagia Toxicities Radiotherapy Parotid gland cancer Cutaneous head and neck cancer 



The authors wish to acknowledge the multidisciplinary Head and Neck team at the Royal Brisbane and Women’s Hospital for their support of this project.

Funding information

This work received funding from the RBWH Foundation Research Grant, 2014–2015.

Compliance with ethical standards

Ethical clearance was provided by the local Human Research Ethics Committee (approval number: HREC/13/QRBW/444).

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

520_2018_4352_MOESM1_ESM.docx (41 kb)
ESM 1 (DOCX 41 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Laura B. Moroney
    • 1
    • 2
    Email author return OK on get
  • Jennifer Helios
    • 1
  • Elizabeth C. Ward
    • 2
    • 3
  • Jane Crombie
    • 1
  • Clare L. Burns
    • 1
    • 2
  • Shu Qi Yeo
    • 2
  • Anita Pelecanos
    • 4
  • Ann-Louise Spurgin
    • 1
  • Claire Blake
    • 1
  • Lizbeth Kenny
    • 1
    • 5
  • Benjamin Chua
    • 1
    • 5
  • Brett G. M. Hughes
    • 1
    • 5
  1. 1.Royal Brisbane & Women’s Hospital, Metro North Hospital and Health ServiceBrisbaneAustralia
  2. 2.School of Health & Rehabilitation SciencesThe University of QueenslandBrisbaneAustralia
  3. 3.Centre for Functioning and Health ResearchMetro South Hospital and Health ServiceBrisbaneAustralia
  4. 4.QIMR Berghofer Medical Research InstituteBrisbaneAustralia
  5. 5.School of MedicineThe University of QueenslandBrisbaneAustralia

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